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The well known general practitioner and outstanding communicator Ann McPherson died on 28 May 2011 from pancreatic cancer. She is celebrated for her books for patients, including The Diary of a Teenage Health Freak (BMJ 2009;339:b3355); the DIPEx (Database of Individual Patient Experiences) charity and its websites (www.healthtalkonline.org and www.youthhealthtalk.org); and Healthcare Professionals for Assisted Dying, the campaigning group that she established and chaired (www.hpad.org.uk). This May, Ann received the BMJ Group’s communicator of the year award (BMJ 2011;342:d1824). Here she gives her final message.

“I’m feeling pretty bloody awful. The nurse and doctor came today to incise the abscess around my chest drain and made the unhelpful suggestion that I might need some antibiotics even though antibiotics make me sick. The GP certainly understands where I am coming from, but when I said that I can’t understand why I have to carry on living like this and why I can’t just die, the nurse said, ‘Well you might change your mind.’

“I think it very unlikely I will change my mind, and even if I did I don’t care. It is nice to see people but if I had the choice there is no question that I would prefer to be dead than to see people. Because I feel so ill. I know everyone is different. It’s nothing specific: I just feel ill, and there seems to be nothing that can make that better. I am already on large doses of morphine and midazolam and haloperidol so that I mostly don’t have pain or sickness—but I still feel ill.

“I feel really furious at this. I think it is cruel. In my practice I saw people who felt like this, and I felt I had let them down. I think my GP thinks that, but all she can do is say is sorry and squeeze my hand.”

We seem still to l be in the era of “Only God can decide when you die”-and some sincerely believe this, as witness the 7.55pm slot on Channel 4 a few weeks ago. This “principle” is behind much of the opinion of religious leaders but is rarely expressed as it invites ridicule or the questioning of how this sits with the notion of a benevolent deity. Why are we still trammelled by this? Let those who hold this view abide by it, but can other doctors not extend to the terminally ill the same consideration a vet showed to my cat when it was suffering and not going to get better; or is that too simple an argument for the theologians,philosophers and ethicists who dominate this debate? What has become of our humanity? Surely a regulated and scrutinised policy of euthanasia in this sort of situation is what a significant percentage of professionals and potential patients ( ie ourselves in other circumstances) want. Is it a good argument that something should be unlawful because a few will abuse it? That argument does not apply to other areas of human activity.

Fadhilamalik

i think anybody in her situation should be helped to die to shorten their suffering!she is a doctor &knows what she is asking for!!

Rupert Gude

So Goodbye Anne, I never met you but I valued reading your words especially about the problems of women in General Practice. Your personal views written when you were diagnosed with breast cancer and then again with pancreatic cancer should be compulsory reading for any caring doctor.I will miss your words.